First-time mom, Qwencie Smith, 22, plays with her son Elijah on the floor in their apartment. Engaging Elijah in the things he finds interesting helps aid in childhood development; something she learned in the NFP program.

Tina Duran always wanted to have a child. But she gave up on this idea long ago. She was set on the notion that her life would remain as it was from here on out. She was wrong.

Duran, and her boyfriend of two years Andrew Abeyta, welcomed their son Alex into the world on Jan. 27, 2011. At 41 years old, Duran is a first-time mother and firmly believes in miracles. But this miracle was no walk in the park.

Her pregnancy was difficult and problematic from the start, as she suffered from high blood pressure and chronic back pain. Baby Alex rested on a bundle of nerves near her spine that caused her right hand to go numb. As a massage therapist, this proved to be severely troublesome. By the end of her seventh month, her left hand also went numb. Duran had to step back from her career until she had her baby.

Three weeks before her due date, Duran developed pre-eclampsia, a condition that causes blood pressure to spike. She was ordered to have an emergency Caesarean section.

"He (Alex) was supposed to be a Valentine's baby," Duran says. "He's a miracle is what he is."

Duran was lucky to have finally become a mother. It was one thing that she had always dreamed of, but it was also the one thing that she was most afraid of.

A trip to the Women, Infants and Children (WIC) office, three months into her first pregnancy gave Duran some very helpful information.

A HELPFUL PROGRAM

Nurse Family Partnership is a voluntary program for low-income, first-time mothers, who are partnered with a Registered Nurse to help hone and utilize their maternal instincts. Women who sign up with the program visit with their nurse weekly for the first four weeks and then once every two weeks until the baby is born.

After the child is born, a nurse visits with the moms once again every week for six weeks and then every two weeks until the baby is 21 months of age. At that time they go to monthly meetings in order to wean the mother and the child from the program. When the child turns 2, the family graduates from the program.

Duran, with the encouragement of Abeyta, immediately signed up for the program. She met with her nurse, Bobbi Lock, the following week.

Lock and Allison Duran (no relation to Tina Duran) are the only RN's trained for the NFP program through the Montezuma County Health Department. It's a busy job. Together they serve 47 families in Montezuma and Dolores counties. Lock has been with the program since it was conceived in Cortez in 2000. Allison came along just a couple years later.

"This program is really about relationships," Allison says. "One between the nurse and the client, and we encourage mothers to develop relationships with their child."

Both nurses agree, that is why the first meetings occur once a week for a month. This is a good time for the nurses to get to know their new moms, and establish a bond. After all, two years is a long time to be together.

Allison has been with her client since she was five months pregnant. Qwencie Smith, 22, was referred by a friend, a former graduate of the NFP program. Her son Elijah is now a year old.

"I had read a few parenting books but I didn't really know what to expect," Smith says. "I was scared. I wanted more comfort and confidence."

Smith comes from a family of six. As the baby, being raised by a single mother, Smith looks to her childhood experiences for future reference. She is also happy that Allison has showed her a few other helpful parenting tips. Smith remembers the first meeting with her nurse, which took place over a year ago.

"I was really nervous," Smith recalls. "I am normally shy and she (Allison) is so bubbly. We went over the first stages of birth. From when a baby is the size of a grain of rice to when they reach full term."

Allison is ecstatic that her client remembers this piece of information. Her buoyant personality comes out. "I'm so proud of you!" Allison says.

GOAL ORIENTED

First meetings are generally a get-to-know-you period. The nurses may talk about feelings the mothers have toward pregnancy, short term or long term life goals or the purpose and expectations of the program.

The NFP program has three goals. The first is to promote healthy prenatal practices. Secondly, to provide first time parents with educational tools in child health and development. And lastly, to engage parents in long-term family goals to sustain economic self-sufficiency.

Each mother may have different long-term goals. Some may want to graduate from high school, get their GED, buy a home, find a full-time job or enroll in college. It is the nurses' job to encourage, support and guide these women in the right direction.

Smith and her husband of three years, Quinn, just bought their first home. They currently live in a two-story apartment. Smith says the apartment was meant as a starter home. Her growing family needs more room, and Allison couldn't be more happy for her.

"I am so excited for her! Our next meeting will be in their new house," she says. "We are very proud of our moms."

Smith and Allison are currently in the stages of healthy eating for toddlers. Smith lists several informational tips on lead poisoning, independent play and object permanence. Each time she says something, Allison bursts with joy, proudly asserting the fact that Smith is retaining information well.

"Babies don't come with instructions," Allison says. "What works for one mom, may not work for another. We are here to help them figure out what does work for them."

Elijah's second birthday will be tinged with sadness for Smith. That's when her time with Allison will come to an end. She says it took a long time for Elijah to warm up to Allison. Mother and son have both grown.

"I've come to rely on her a lot," Smith says with warm sentiment. "If I have questions, I call my mom first because she's had so much experience but Allison is a close second."

Smith isn't worried about Allison's departure because the nurses leave each mother enormous parting gifts. Three very hefty three-ring binders, overflowing with educational information, passed on to them from each meeting. Each binder covers a different phase. Pregnancy, infancy and toddlerhood.

PROVIDING TOOLS

After Duran meets with Lock, she reads over the binder again to make sure she doesn't miss anything.

"It's a great reference tool," Tina Duran says. "When I don't see Bobbi (Lock) or I can't talk to her, I look at the book."

She also expresses how sad she will be when Lock leaves. She says Lock is a nice person with a welcoming attitude. The type of person to open her door, invite you to sit and bring you some coffee.

Lock has helped this little family tremendously. She has taught them to stay calm and have patience. The parents often discuss things such as discipline tactics and healthy eating habits, to find common ground.

Abeyta is present at every meeting. He is thankful for the lessons and help that the NFP program has provided.

"Some people would think it was an invasion of privacy," Abeyta says. "Like if they don't want someone else telling them how to raise their child. But I see it like this, she gives you the tools and it's up to you if you want to use them. If someone is giving you a more simple, beneficial way to do something, wouldn't you rather do it their way?" Alex is now in the first stages of walking. He grabs the edge of couches, tables and chairs. He crawls when he can't feel his way around an object. Duran is surprised a year has already gone by. She and Abeyta have a huge first birthday celebration planned for their little miracle. Duran is making a pinata. Both families are prepping for the big day. Duran's family is especially happy for her. She and Abeyta receive lots of love and support. They all know how important it was for her to have a child.

Rachel Segura/Cortez Journal
Elijah Smith, a curious one year old, abandons his toys to inspect the camera. His mother Qwencie describes her son as “independent.”

NFP Statistics

This data was collected from Oct. 1, 2010 to Sept. 30, 2011 for the state of Colorado and the Nurse Family Partnership Programs that serve families in 50 counties. It was found at www.nursefamilypartnershipprogram.org under state profiles.

Positive outcomes for clients:

38 percent of mothers who entered the program without a diploma or GED have since earned one.

There was a 47 percent reduction in domestic violence during pregnancy.

91 percent of babies were born full term and 90 percent were born at a healthy weight- at or above 5.5 pounds.

90 percent of mothers initiated breastfeeding and 35 percent continue to breastfeed at six months.

Client demographics: (at intake)

Median age: 19

82 percent unmarried

65 percent medicaid recipients

55 percent White

32 percent decline to self-indentify/No response

5 percent Black or African American

3 percent multi-racial

3 percent American Indian

1 percent Native Hawaiian/Pacific Islander

1 percent Asian

45 percent Hispanic/Latina

51 percent Non-Hispanic/Latina

4 percent declined to self-identify/No response

National Recognition:

The Washington State Institute for Public Policy, The RAND Corporation and The Brookings Institution have concluded that investments in Nurse-Family Partnership lead to significant returns to society and government, giving taxpayers a $2.88-5.70 return per dollar invested in the program.

The non-profit, non-partisan Coalition for Evidence-Based Policy finds "strong evidence of effects on life outcomes of children and mothers" by Nurse-Family Partnership.

The Center for the Study and Prevention of Violence reviewed over 650 programs with published research in peer-reviewed literature. Nurse-Family Partnership is one of only 6 percent of the programs that clearly work, or even appear promising.

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Monday, March 30

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